The Risk Register - which was prepared by civil servants in the Department of Health - grades potential risks according to "likelihood" and "impact", giving an overall score based on the two, which is then colour coded. The document is almost a sea of red for danger. Amongst the Department's top fears are:

"the Bill proceeds on basis of incomplete /flawed design"

"the Bill proceeds without assurance that the whole system is affordable" - particularly when private sector costs are factored in

Lack of planning for the transition to new system

"Financial control is lost due to the restructuring of budgets"

"By dismantling the current management structures and controls, more failures, including financial, eg GP consortia go bust or have to cut services, and credibility of the system declines as a result."

Staff morale will be severely impacted by the changes

"There is a risk that the transition will be presented in a negative light via the media. Two of the biggest risks which have already surfaced in the media are i) that the reforms will continue to be characterised through the prism of privatisation and ii) financial cuts."

If rationality and the public good had anything to do with the workings of the state, the Risk Register would have provided a powerful case for dumping the NHS bill, especially when the NHS already enjoyed such huge levels of public satisfaction. Unfortunately for all but those who will profit from the great healthcare carve-up, the reform is only rational from a money-making perspective. The Risk Register is proof that the government recklessly and wilfully ignored the very real risks to public health, for the sake of their own careers and wallets.